Provider Demographics
NPI:1629281613
Name:LOVING TOUCH PERSONAL CARE SERVICE, INC
Entity Type:Organization
Organization Name:LOVING TOUCH PERSONAL CARE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TILLNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWSON
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:318-559-0018
Mailing Address - Street 1:1512 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:LAKE PROVIDENCE
Mailing Address - State:LA
Mailing Address - Zip Code:71254-3630
Mailing Address - Country:US
Mailing Address - Phone:318-559-0018
Mailing Address - Fax:318-559-3818
Practice Address - Street 1:1512 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:LAKE PROVIDENCE
Practice Address - State:LA
Practice Address - Zip Code:71254-3630
Practice Address - Country:US
Practice Address - Phone:318-559-0018
Practice Address - Fax:318-559-3818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LASIL 7208251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1004065Medicaid